1. Home
  2. Directory
  3. Oregon
  4. Salem
  5. Dentist
  6. NPI Profile

GARY T. PEDERSON
NPI 1154517415
Dentist - Oral and Maxillofacial Surgery in Salem, OR

Active since September 20, 2007
1565 LIBERTY ST SE, SALEM, OR 97302(503) 581-0223(503) 581-6794 Get Directions Write a Review

NPPES record last updated: September 20, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gary T. Pederson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY T. PEDERSON (NPI 1154517415) is a healthcare organization registered as an oral and maxillofacial surgery in Salem, Oregon and active in the NPI registry since September 2007. The organization lists Gary T Pederson, Oral Surgeon, as its authorized official.

NPPES Registry Identity

NPI1154517415
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameGARY T. PEDERSON
Location Address1565 LIBERTY ST SESalem, OR 97302-4345
Mailing Address1565 Liberty St SeSalem, OR 97302-4345 · (503) 581-0223 · Fax (503) 581-6794
Phone(503) 581-0223
Fax(503) 581-6794
Organization SubpartNo
Authorized OfficialGary T PedersonOral Surgeon · (503) 581-0223
Enumeration DateSeptember 20, 2007
✔ NPI 1154517415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in OR · D4658
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1565 LIBERTY ST SE, Salem, OR 97302
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN0000NGBMVOR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID C SWIDERSKI DDS, MD
Oral & Maxillofacial Surgery
1565 LIBERTY ST SE
SALEM, OR 97302
Marion County (503) 581-0223
MID-VALLEY ORAL, MAXILLOFACIAL & IMPLANT SURGERY
Clinic/Center (Oral and Maxillofacial Surgery)
1565 LIBERTY ST SE
SALEM, OR 97302
Marion County (503) 581-0223
GARY THEODORE PEDERSON D.D.S.
Dentist (Oral and Maxillofacial Surgery)
1565 LIBERTY ST SE
SALEM, OR 97302
Marion County (503) 581-0223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary T. Pederson's NPI number?

The NPI number for Gary T. Pederson is 1154517415. It was assigned to this organization in the NPPES registry on September 20, 2007.

Where is Gary T. Pederson located?

Gary T. Pederson is located at 1565 Liberty St SE, Salem, OR 97302. The listed phone number is (503) 581-0223.

What is Gary T. Pederson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Gary T. Pederson was last updated on September 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.